Analysis of the effectiveness of the developed system of physical therapy for patients with rheumatoid arthritis in terms of daily activity, health status and quality of life

Anzhela Nogas; Igor Grygus; Serhii Hutsman; Valerii Diachuk; Ivanna Blayda

doi:10.15391/prrht.2024-9(2).07

Authors

Anzhela Nogas Institute of Health Care, National University of Water and Environmental Engineering, Rivne, Ukraine https://orcid.org/0000-0003-1287-9828
Igor Grygus Institute of Health Care, National University of Water and Environmental Engineering, Rivne, Ukraine https://orcid.org/0000-0003-2856-8514
Serhii Hutsman Institute of Health Care, National University of Water and Environmental Engineering, Rivne, Ukraine https://orcid.org/0000-0002-1817-6835
Valerii Diachuk Institute of Health Care, National University of Water and Environmental Engineering, Rivne, Ukraine https://orcid.org/0009-0006-6502-1787
Ivanna Blayda Department of Rehabilitation and Human Health, Stepan Gzhytskyi National University of Veterinary Medicine and Biotechnologies of L’viv, L’viv, Ukraine https://orcid.org/0009-0000-7302-102X

DOI:

https://doi.org/10.15391/prrht.2024-9(2).07

Keywords:

rheumatoid arthritis, physical therapy, system, daily activity, health status, quality of life

Abstract

Purpose. The purpose of the article is to analyze the effectiveness of the developed system of physical therapy for patients with rheumatoid arthritis based on the results of indicators of daily activity, health status and quality of life.

Material & Methods. 188 patients with rheumatoid arthritis were examined, including 156 women (83%) and 32 men (17%), with an average age of 44,9±7,6 years. The patients were randomly divided into a control group (n=92) and a study group (n=96). Patients in the main group were trained according to the proposed system of physical therapy, which was developed in accordance with the domains of the ICF, taking into account factors affecting the level of functional impairment, health status and quality of life (categories at the level of activity and participation). In the dynamics, a comparative assessment of functional limitations in the daily activity of the upper extremities was performed using the DASH questionnaire, health status assessment using the Stanford Health Interview, and quality of life using the EuroQol-5D-5L questionnaire.

Results. In patients with rheumatoid arthritis, the initial examination revealed impaired performance of daily activities, in particular, activities requiring hand strength according to the DASH questionnaire, low self-assessment of health according to the Stanford Health Assessment Questionnaire, and significant deterioration in quality of life (EQ-5D-5L) due to the negative impact of existing functional impairments of the upper extremities. After the rehabilitation intervention, patients in both groups showed statistically significant improvement in all studied indicators: facilitation of performing household activities in everyday life, increased self-assessment of health, and improved quality of life compared to baseline data (p < 0.05). However, patients in the main group showed a significantly better result than patients in the control group, which indicates the effectiveness of the proposed rehabilitation measures (p<0.05).

Conclusion. Significantly better differences between patients of the main and control groups were found according to the results of the studied indicators, which clearly demonstrates and confirms the effectiveness of the proposed system of physical therapy in contrast to the standard rehabilitation system.

References

Babak, O.Ia, Rozhdestvenska, A.O., & Zhelezniakova, N.M. (2021). Management of a patient with joint syndrome. Modern practice of internal medicine with emergency conditions. KhNMU.

Boers, M. (2021). Patient global assessment to define remission in rheumatoid arthritis: quo vadis? Ann Rheum Dis., 80(3), 277-279. https://doi.org/10.1136/annrheumdis-2020-218802

Bogdanovska, N.V., & Boichenko, K.Yu. (2023). Modern strategies for restoration of daily activity in rheumatoid arthritis. Rehabilitation & recreation, 17, 23-31. https://doi.org/10.32782/2522-1795.2023.17.3

Cieza, A., Causey, K., Kamenov, K., Hanson, S.W., Chatterji, S., & Vos, T. (2020). Global estimates of the need for rehabilitation based on the Global Burden of Disease Study 2019: systematic analysis for the Global Burden of Disease Study, 2019. Lancet. 396(10267), 2006-2017. https://doi.org/10.1016/S0140-6736(20)32340-0

EQ-5D [Electronic resource]. https://euroqol.org/

Grygus, I., & Nogas, A. (2020). Main provisions of the concept of physical therapy for patients with rheumatoid arthritis. Journal of Education, Health and Sport, 10(3), 340-351. https:// doi.org/10.12775/JEHS.2020.10.03.037

Grygus, I., & Nogas, A. (2023). Comprehensive analysis of pain syndrome in patients with rheumatoid arthritis. Med. perspekt., 28(1), 148-152. https://doi.org/10.26641/2307-0404.2023.1.276049

Grygus, I.M., Nogas, A.O., & Zdanyuk, V.V. (2023). Dynamics of movement amplitude indicators in joints of patients with rheumatoid arthritis. Med. perspekt., 28(4), 166-173. https://doi.org/10.26641/2307-0404.2023.4.294222

International classification of functioning, limitations of vital activities and health: ICF. (2018). World Health Organization. 1048.

Jester, A., Harth, A., Wind, G. et al. (2005). Disabilities of the arm, shoulder and hand (DASH) questionnaire: determining functional activity profiles in patients with upper extremity disorders. Hand J. Surg., 30B, 23-28. https://doi.org/10.1016/j.jhsb.2004.08.008/

Kononenko, N.M., & Chikitkina, V.V. (2022). Basic methods of physical rehabilitation of patients with rheumatoid arthritis. Ukr Zh Med Biol Sportu, 4(38), 19-24. https://doi.org/10.26693/jmbs07.04.019

Korytko, Z.I., Haiduk, O.A., & Bazylchuk, O.V. (2023). The efficiency of physical rehabilitation in patients with rheumatoid arthritis. Rehabilitation & recreation, 17, 76-84. https://doi.org/10.32782/2522-1795.2023.17.8

Nekhanevych, O.B., Kaniuka, Ye.V. (2023). Rheumatoid arthritis: a modern view of the problem and peculiarities of rehabilitation measures. Rehabilitation & recreation, 17, 116-122. https://doi.org/10.32782/2522-1795.2023.17.13

Nogas, A.O. (2023). Dynamics of indicators of quality of life related to the health of patients with rheumatoid arthritis as a result of the impact of the physical therapy programme. Art of Medicine, 4(28), 102-107. https://doi.org/10.21802/artm.2023.4.28.102

Nogas, A.O. (2023). Effectiveness of rehabilitation measures to restore joint function in patients with rheumatoid arthritis. Rehabilitation & recreation, 14, 71-81. https://doi.org/10.32782/2522-1795.2023.14.8

Nogas, A.O., & Grygus, I.M. (2022). Assessment of the functional status of patients with rheumatoid arthritis as a result of the impact of a physical therapy programme. Journal of Education, Health and Sport, 12(11), 390-403. https://doi.org/10.12775/JEHS.2022.12.11.052

Nogas, A.O., & Grygus, I.M. (2022). Changes in functional disorders of the wrist and hand as a marker of the effectiveness of a physical therapy programme for patients with rheumatoid arthritis. Journal of Education, Health and Sport. 12(4), 365-374. https://doi.org/10.12775/JEHS.2022.12.04.03

Order of the Ministry of Health of Ukraine No. 263 of April 11. 2014. Rheumatoid arthritis adapted evidence-based clinical guideline: www.moz.gov.ua.

Studenic, P., Aletaha, D., de Wit, M., Stamm, T.A., Alasti F., Lacaille D., et al. (2023). American College of Rheumatology/EULAR Remission Criteria for Rheumatoid Arthritis: 2022 Revision. Arthritis Rheumatol., 75(1), 15-22. https://doi.org/10.1002/art.42347

Sytnyk, O.A. (2023). Patient survey in the activity of a physical therapist: a study guide. Sumy State University.